Utility of Residency Milestones Reported to Fellowship Directors: A National Survey of Pediatric Fellowship Program Directors.

Abstract

The Accreditation Council for Graduate Medical Education recently made available final residency Milestones for first-year fellows to fellowship program directors (FPDs). Usefulness of residency Milestones for fellows is unknown. Our objective was to determine how many pediatric FPDs downloaded final residency Milestones for their first-year fellows and FPD perspectives about usefulness of residency Milestones. Mixed methods survey of pediatric FPDs, assessing FPD use of residency Milestones for first-year fellows, and FPD opinions about utility of residency Milestones for fellowship, including during fellow recruitment. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis. The response rate was 67.8% (544 of 802). Only 39.3% (209 of 532) of FPDs downloaded final residency Milestones for their first-year fellows. Twenty-four percent (129 of 532) of all FPDs thought residency Milestones were useful. Forty-one percent (218 of 532) thought residency Milestones would be useful during recruitment; others believed this may harm applicants. Of FPDs that downloaded and reviewed residency Milestones, 27% (50 of 185) used them for individualized education. FPDs felt residency Milestones might allow for identification of trainee needs and baseline assessments, but thought that residency Milestones had limited usefulness during fellowship due to concerns about lack of validity evidence, relevance, and how Milestones are assessed and reported. Most FPDs find residency Milestones to be of limited utility for their fellows and do not use residency Milestones to tailor education for their first-year fellows. Improving relevance of residency Milestones to fellowship training, validity, and how Milestones are assessed and reported may improve their usefulness for fellow training.